| NPI | 1063774347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 54272) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC LL34793) |
| 207L00000X Anesthesiology (Licence: SC LL34793) | |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2022-12-28 |